Page 43 - Cover Letter and Evaluation for Barbara Lesswing

11/20/2017 Your Plan Results Good plan but
BlueCross BlueShield BlueSaver (HMO) (H3384-062-0) provider network is
Organization: BlueCross BlueShield of WNY and BlueShield of NENY only one-half as large
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
as your current plan.
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Dr. Lasci is not listed
Coinsurance: and Other Drug
[?] Programs: Costs: [?] in this plan's network.
Retail $0.00 Annual Drug Doctor Choice: All Your Drugs on $5,110 Enroll
Deductible: Plan Doctors Formulary :Yes
Pharmacy Drug: $0.00 $290 for Most 4 out of 5
Status: Health: Services Drug Restrictions: stars
Preferred Cost- $0.00 Health Plan Yes
Sharing Deductible: $0 Out of Pocket Lower Your Drug
Part B Drug Copay/ Spending Costs
Annual: $1,459 Premium Coinsurance: $2 Limit: $6,700
Reduction - $85, 27% In-network MTM Program :
Mail Order :No Yes
Annual: $1,439
Univera SeniorChoice Basic (HMO) (H3351-017-0)
Organization: Excellus Health Plan, Inc
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor Choice: All Your Drugs on $5,540 Enroll
Deductible: Plan Doctors Formulary :Yes
Pharmacy Drug: $0.00 $360 for Most 4.5 out of 5
Status: Health: Services Drug Restrictions: stars
Standard Cost- $0.00 Health Plan Yes
Sharing Deductible: $0 Out of Pocket Lower Your Drug
Part B Drug Copay/ Spending Costs
Annual: $1,782 Premium Coinsurance: $0 Limit: $6,700
Reduction - $100, 25% In-network MTM Program :
Mail Order :No Yes
Annual: $1,583
Fidelis Medicare $0 Premium (HMO) (H3328-020-1)
Organization: Fidelis Care
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor Choice: All Your Drugs on $5,410 Enroll
Deductible: $0 Plan Doctors Formulary :Yes
Pharmacy Drug: $0.00 for Most 3 out of 5
Status: Health: Health Plan Services Drug Restrictions: stars
Standard Cost- $0.00 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: $0 Spending Costs
Annual: $1,785 Premium - $100, 33% Limit: $6,700
Reduction In-network MTM Program :
Mail Order :No Yes
Annual: $1,578
BlueCross BlueShield Senior Blue Select (HMO) (H3384-058-0)
Organization: BlueCross BlueShield of WNY and BlueShield of NENY
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $46.00 Annual Drug Doctor Choice: All Your Drugs on $5,230 Enroll
Deductible: Plan Doctors Formulary :Yes
Pharmacy Drug: $46.00 $180 for Most 4 out of 5
Status: Health: Services Drug Restrictions: stars
Preferred Cost- $0.00 Health Plan Yes
Sharing Deductible: $0 Out of Pocket Lower Your Drug
Part B Drug Copay/ Spending Costs
Annual: $1,883 Premium Coinsurance: $2 Limit: $6,700
Reduction - $94, 29% In-network MTM Program :
Mail Order :No Yes
Annual: $1,866
WellCare Value (HMO) (H3361-136-2)
Organization: WellCare

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